Delivery of pharmaceutical services and care at three primary healthcare clinics with different dispensing models in the Nelson Mandela Bay Health District

As South Africa moves into an era of National Health Insurance (NHI), the idea of primary health care (PHC) re-engineering is placed at the forefront; however, the role of the pharmacist in this process remains vague. Task-shifting of the dispensing process to pharmacist’s assistants and nurses in PHC clinics is a common phenomenon, but the implications of this on the provision of pharmaceutical services and care to patients is largely unstudied. Thus, this study aims to explore these pharmacist-based, pharmacist’s assistant-based and nurse-based dispensing models present in PHC clinics. A two-phase, mixed methods approach was utilised, comprising of a pharmaceutical services audit and semi-structured interviews. The interviews provided insight into the lived experiences of personnel and patients of pharmaceutical care provision. Results revealed that although basic pharmaceutical services may be available at clinics with each of the three dispensing models, the quality is of a varying standard due to challenges in infrastructure and maintenance and poor personnel support. Furthermore, the provision of quality pharmaceutical care is minimal with all three dispensing models, resulting in a missed opportunity to optimise patient health outcomes in patient-centred PHC

Appraising risk of development of cardiovascular disease in patients with type 2 diabetes mellitus

Background: Research shows a strong relationship between type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). Most commonly, diabetic participants experience increased morbidity and mortality due to CVD complications. This study aims to determine the proportion of CVD prevalence and to evaluate the risk factors for developing CVD among T2DM participants and to evaluate the CVD risk factor for the next 10 years using Joint British Societies recommendations on the the Prevention of Cardiovascular Disease (JBS3) scale. Materials and Methods: In this hospital-based observational study, data including serum creatinine, blood urea, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very LDL, echocardiography, and ECHO readings were collected from a random sample of 106 participants, both diabetic and nondiabetic. The risk of developing CVD in participants with DM in the next 10 years was evaluated using the JBS3 risk calculator through analysis of collected data. Results: Among 106 participants, there were 72 participants with DM, and the majority of these participants had comorbidities, including hypertension and other CVDs. According to the data collected from DM participants, it was observed that 77.77% had elevated serum creatinine value, 27.77% had elevated blood urea level, 61.11% had abnormal HDL value, 65.27% had elevated LDL value, and 26.38% had elevated VLDL value. Total triglycerides level was also observed to be high in 54.16% of the DM participants. Moreover, the results indicated that CVD was present in 77.78% of type 2 diabetic patients, which was comparatively higher than in nondiabetic participants of whom 32.35% had CVD. Conclusion: Based on the data collected and results obtained from the JBS3 risk calculator, it was found that the participants with DM were at higher risk of developing CVD